As the coronavirus pandemic spreads worries the poor nations wont be able to cope Health Systems are weak in many of these countries and millions of people dont have access to clean water or sanitation so how can we avoid a catastrophe this is inside story. Hello welcome to the program and its corona virus infections have now been reported in nearly every country in the world and the number of people getting sick in europe on the United States is rising rapidly. But scientists warn the next big spike could occur in developing nations we already weak Health SystemsJohns Hopkins university in the u. S. Has been tracking the pandemic for the past 3 months now theres a huge concentration of cases in china iran europe and the u. S. Few are infections in latin america and across africa but those numbers are ticking up in countries like nigeria for instance africas most populous nation is also battling the Worlds Largest outbreak of last a fever a viral disease more fatal than covert 19 liberia where more than 4000 people died of a bowler in 2014 its declared a state of emergency and in the caribbean haiti is still recovering from natural disasters and an outbreak of cholera the u. N. Is asking for 2000000000. 00 to help poor nations i have just sent a letter to the leaders of the g. 20 i think it is clear that we need a much stronger coordination coordination in suppression of the disease coordination in making sure that not only the developed countries can respond effectively to lizzies but that there is massive support to the developing world not to let the disease spread like wildfire in the developing world here are the main challenges that developing nations face in their fight against the pandemic millions of people do not have access to basic washing facilities sanitation and hygiene and many cant afford to buy hand sanitizers isolation is nearly impossible in densely populated nations outbreaks could be devastating particularly in countries hosting refugees and internally displaced people many of those nations Health Systems like medical supplies or theyre overstretched. And according to the w. H. O. Poor nations spend on average 41. 00 a person on health care 70 times less than richer countries. And so lets introduce our panel joining us from new delhi is our former secretary of health in india from whole massachusetts in the United States weve got dr Sheila Davies the c. E. O. Of partners in health and from nigerias capital a bugger for a doctor and the director of policy and advocacy at Nigeria Health watch welcome to you all and thank you for joining us ill start with you fine in nigeria and its a question i posed to all of you do you think that the countries outside the epicenter of the krona virus so far so countries in africa latin american india theyre going to escape the worst or are we waiting for it to come to them if im. Ok thank you so much for having me on the show um i think i think bernie my. The recent measures are being put in place by one jew and other african other african countries you know by shots on the borders. Stopping flights from coming into the country and the continent as a whole. We may be able to skip it however we know there are challenges that we have that africa that a lot. So some of the challenges that we have include you know like you mentioned when you did the intro the very densely populated cities that we have very you know with public transport system and i think you know in nigeria religion is also a big issue because you know people believe that some of the sense will not affect them because of the you know the kind of god that he washing. So i you know ill keep my fingers crossed on that because i know that in niger. Most of the cases for show i imported what the challenges are silent we have now is tracing the contents of those cases and everybody else on the flight on those flights that came in with you know with those cases are being confirmed so fast and that that that is going on but also is also proving to be challenging for you know for public for the Public Health authorities that are tracking these cases and she will have the developed countries in the developing world spotted the dangers of early enough to think and i worry that we havent done enough testing to actually know the full burden this disease i think theres been there is little testing theres then turn in many places as partners in health works around the world is then good efforts that governments have tried to just has not then access to testing in the right ability to do the p. C. R. Tests which can usually only be done in central labs so i worry that there is more of a burden then we think there is i do think that when government has done a good job and. Trying to. Shut down the orders etc but there is we know that there certainly this virus has has gotten around that already and in other places so i have fear that once its in the country we dont have the Health Systems and to be able to address the real issue and armor bid it immortality will be higher so just the raw india has closed the country off to International Flights has now stopped domestic flights has india done enough to nip the spread of corona virus in the bot. You know do they need to have cups of it had they do in get did. The seating of the borders if you said suspended the. Wine and today as from sunday on words you have mocked on the whole country so social distancing is the taken to its logical conclusion very very seriously youre not going to be a factor commentary several different Political Parties governing different states but even then there has been a united and its very impressive that the whole kind of g. Has been locked down. Having set that had been designed. This has you know should we have done this. Or at all because it clearly back on time and weve used this window of opportunity that we have to the end of this month before we suspect that the inspection me getting to the community then it will become very very difficult because. Due to the density of population and out of there youre not even necessarily any quid use that there that the Health System it may be difficult to do that either out of patients coming up at the same time so it is strategy is really to flatten the epidemic and take what it comes back to indoors and which dont get caught up with so i think in this because we know that we have one week we hope that theres not going to have that efficiently impact and secondly view it all to expanding if jesting jim that we will be focused on those who came from abroad but were going to be guesting if the patient who shows up in the hits this in the rabbit with symptoms that me his number of total must move so that should then be really be able to get very good information as to the tragic hero of this infection and where the bible says but its. Going to be due. Here if you know more than what the. Ok thank you and a fine for many countries population in the developing World Population density is a challenge youve heard of this lockdown in india in nigeria only partial lockdowns in a budget and lagos of lagos particularly very densely populated city has nigeria done enough or should it be doing much more very quickly. To be honest not only not in that sense both have to bear in mind that nigeria is a federation so thats the federal government the state governments and local council the federal government has shown tremendous leadership in coordinating and making sure the states actually adopt the measure that they put in place and apart from lagos are not good there are some other things they have also. Put in place shut down of of the of the of the domi. One of the states close here and i just theres a curfew from. Candlestick which is also a very densely populated state and in the country similar to lagos has also put similar measures in place. And across across the entire country because Civil Servants are what for the parent government in every state. The federal Civil Service has also put in place measures to ensure that workers from level one to 12 do not want to walk the walk remotely from home. But having said all of this i think state governments and there are a lot more. And i think i need to go back again to the fact that its a deeply religious country well it just does have an awesome responsibility in this regard because when i said last sunday when the problem i had announced that. Limits issue god reason charges and burials and stuff some negative Health Services that people attended so they have a very Important Role to be our religious leaders to make sure that people stay at home because we know that. When less people go to war that cant walk mostly people can walk remotely people dont go for social gatherings then we can even begin to manage you know the population that would go around in public transport you mention legals legalizes the places that want to talk about infection will get scared because of the density. Ok what i think. Even before the average we got our press gave italian welcome to new gods that exhausted government had already put you know a step up on is vent Management Committee that it had the added by the governor so that level of political commitment is what we want to see replicate that across every state in one you have because. If we dont do that i den you know then it kind of becomes scary when this infection begins to get to places like Bottomless Pit where you have infinitely displaced persons as a result of a quote on his legacy all right a fine and sorry to interrupt sheila can i ask you what are you hearing from your colleagues on the ground places like rwanda haiti peru particularly what all their main concerns as they see what has been happening in europe and the u. S. You know i think we want to for example has done a very aggressive job in tech tracing so when theyve had cases they have done extensive kind of check tracing and isolation and quarantine as needed and i think has has taken a very proactive approach. In other places i think the government in haiti is trying i think the same challenge of density is there and theres also quite a bit of fear in stigma and of people who potentially have the virus so similar to what weve that old during a bowl in west africa a lot of Community Education is really critical so people are not fearful of people who have the virus but are encouraging them to get care and to allow us to do really deep Community Outreach if we get into the same situation that we ended up with for a while during a bolo where people were shunned and there was now that people were not encouraged to get care and were going to continue to have a lot of Community Transmission so i think a really effective Community Outreach as well as facilities all the way up to the ministries of health has to be the way they go sheila you were in liberia during the. Outbreak i mean what what was the what was the biggest lesson you think from that that youve been able to that you can pass on to dealing with coronavirus you know we were in lets serially and we were i was spent most of my tenants really in so maybe areas but it was clear that we had to reduce some of the fear and we had to engage our Community Partners so we mobilized the survivors to act as Community Health workers to go out into case finding and and find people and thats the strategy there are utilizing now in partners in Health Countries is to utilize our Community Health worker workforce to be going out and were training them to be contact racers and to be doing a lot of education because if were we took too long to do that during a bola and we kept it very very separate and that really caused a lot of people to delay coming in for help and assistance which allowed the a virus to continue to spread suggest of the coronavirus is putting Health Care Facilities in developed countries under enormous stress could india Indias Health care system handle a severe outbreak of coronavirus. You know john depends on how intensive then and how spread out it is a number of the cases that we get because of the kind of base were just had 90 a tentative of or 500. To be reinspected for instance so it seems to be manageable if this is the way it is but were not in search and if its wont do what we please. At the rate of that at the country then we may be ending up with a very which is ludden and our. System of Health System it wont be perfect to take a very large. Particularly in the middle part of the country which is water and has a week ahead system we have shortage of doctors we do have problems. A 1000000 population and even get to the p. P. P. Me ease that the protective gear and was kind of essential consumables would be a challenge but we had a manner of these jet engines and the government appears to be taking action to china and you know still focus on the prevention and market and to stop the transmission of the bidens to get to the community that still seems to be the best bet for those of the best. But having said that if it does get exponentially if it spreads. Exponentially lana we have to deal with it but then the whole system of the 101. 00 of the world can do good lady knowledge anomalous thats whats shown so were just hoping that we have adequate to get past it were hoping in the private sector and the public sector. That this need to be. A march and then go here getting in doctors from all of the sectors to Work Together they design it like now you do your locals you have to see as the epidemic unfolds but it is going to be definite. And they need this challenge. And were all used to hearing by now about the import of social distancing and the importance of washing your hands for that all important 20 seconds but if fine when 3 quarters of the households in developing countries dont have access to soap and water to wash their hands what do you say to people when the most important thing they can do they can do it ok i think 1st of all is to remind people that bleach was serious you wash your hands with soap and Running Water quality 2nd Running Water does not necessarily mean what are coming out of a fight bye bye bye bye what are your home run what are called me somebody pouring water while youre washing your hands. So thats a reminder that you know we get people through your health ward and we also need people to to understand that theres a tradeoff here. So you need to go to the extra mile because you know that if you dont do this what these are will some of the consequences are so that you realize that youre doing is youre not just feeding yourself but also youre saving your family or saving your loved ones because everybody really has to chip in. I see ourselves as 19 is what i was we know that the preventive measures are very busy that people really all know we should be doing on a daily basis its just that i this point in time we just need to retread the fact that people have to do this even if it means going the extra mile to do it because we know that if we dont have what i was in the hole. What then Running Water is somebody also pouring water for you while you wash your hands and this is something people really have to commit to because its doing it really for public good as well as for Public Health she rather seems to be more of a recognition across africa of the dangers proposed by coronavirus when compared to latin america where there seems to been a bit more of a mixed message next a cone brazil not initially taking the. That seriously have you noticed that in lots of america was a less a less alert to the dangers that we think of the moment i think you know and in peru our team in peru has been working very hard in the government there has been very very proactive in the areas we work in in really advocating to get Rapid Testing in the country in tests that were purchased from china and have have very much said they wanted to be proactive about that in mexico i think theres been less of an effort but i think in haiti there is certainly ben a a people being very aware and not knowing exactly how to address when the Dominican Republic got a few cases a few weeks ago we we all went to support it and waited for the onslaught and it hasnt appeared yet again i think partially because of the lack of testing but i think theres 9 cases now in haiti but i think theyre trying very much to address this i think the lack of a robust Health System is really this is where this becomes even more evident that we dont have enough beds for people to have normal care to have you know to have c sections for women obstructed labor in many places that we work so adding this on top of that the regular routine care that people are not showing up for it is also really going to impact peoples lives and we often dont talk about that we often talk about just the buyers of the pandemic itself theres a lot of the secondary things that people are not going to get in care for as well which are going to be very problematic and caused deaths. We all know how significant social media is particularly in the developing world. We know in india youve had problems in the past with fake messages spreading on via whatsapp groups is how important is it to control the message in india tend to clamp down on fake news on fake you was a rumors of a fake yaws oh you know its a state rationale you might get hurt. So thats a get rid of that state and then we should if it is shown that any fake news. Is not any news on what are not in to whats that they were in that take action you know this will be keeping complete control on arm that is the kind of information thats being shared even on whats that which is in dispute. Sanct and actually want people who have been. You know to get into the zone and so on so forth so theyre trying to but then you know the social media is such a. Why do network its going to be difficult except that to the minute mass we get channels we are doing and they do the very good job of giving the right information trying to can give best informed as to how of their infection spread and how dozens and luck to going for war here he is of kyoto and meant and departed the facilities and to the hospitals thats going on but then you know vasu 20 that with all kinds of believes that if this is likely to happen it happened in the object here if we can recall we saw that. And now that this infection the kind of speed with which it tends to have a slow glow theres bound to be this kind of whom im on going and will stand off with meekness theyll be its better to challenge what i have that chance their best. Its. Funny you mention the importance of religious leaders a nigeria very religious country are they being responsible because they in the past its religious groups or respect spread rumors about previous. Viruses an epidemic are they paying attention this time around well some have to be honest weve seen videos of on very ridiculous statement some of the religious leaders have made in the past the past 5 days or so. But i think what is happening is that. A lot of people are really also beginning to push back at least on social media when they see such messages people realize this cannot possibly be true people are pushing back what if theres anything weve learned through the work with your health watch is that we cannot observe that people actually know about some of the Public Health message in this which i will just lead and so what we do is to try to engage them for them to see the reasons why they need to give you this to make sure that the message in our really true health. But in particular which respected this break weve seen some very difficult statements as called religious leaders and we hope that as we go forward. A lot more of them will become more responsible to ensure that the message in the put out is very positive let me give you an example but you see the religious need is also a program pulled out of society. Last week we had an opinion poll of about a 1000 people across the country to ask them about their perceptions of the coronavirus and 26 percent said that they believed they were immune to the corner virus and the reason is the those 26 percent gave include things like the fuel that the our children of god. They feel that this is for africa they feel that is thick enough to not have dull protect them from from this particular disease and of. God that all 40 percent of the 26 percent said that they believe that they are children of god that kind of takes you back to what the kind of creature that did get and talk to us on mars were invited to the washington normally if i thought i was going to squeeze one last question in to just very quickly as you know the u. N. Says it wants 2000000000. 00 to help pay for the development of developing will to tackle coronavirus whos going to come up with that money when theyve all got problems of their own the developed world has got enough on its plate are people going to pay to think how i hope so i think that people will appeal to peoples humanity to realize although its challenging here we know its going to be much more challenging in a place like haiti where theres one ventilator approximately 3000000 people so i hope that people will be able to look beyond their own backyard and know that theres challenges here but at the end of the day where most of us are in a functioning Health System where there will be death and destruction but nowhere to the levels that theres going to be in places in the world would where there are such weak Health Systems so im hoping that humanity will prevail and that people will reach out and try to build a Health System not just for the emergency but so that we can mitigate the next emergency thats going to come or at least give people a chance or not thank you very much unfortunately we are out of time but thank you very much for insights thanks to all of our guests so John Rau Sheila Davis and the fun so for and thank you too for watching you can see the program again any time by visiting our website aljazeera dot com and for further discussion go to our Facebook Page at facebook dot com forward slash a. 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